Using multimodal mining to drive clinical guidelines development.

We present exploratory investigations of multimodal mining to help designing clinical guidelines for antibiotherapy. Our approach is based on the assumption that combining various sources of data, such as the literature, a clinical datawarehouse, as well as information regarding costs will result in better recommendations. Compared to our baseline recommendation system based on a question-answering engine built on top of PubMed, an improvement of +16% is observed when clinical data (i.e. resistance profiles) are injected into the model. In complement to PubMed, an alternative search strategy is reported, which is significantly improved by the use of the combined multimodal approach. These results suggest that combining literature-based discovery with structured data mining can significantly improve effectiveness of decision-support systems for authors of clinical practice guidelines.

Assessment of PEO/PTMO multiblock copolymer/segmented polyurethane blends as coating materials for urinary catheters: in vitro bacterial adhesion and encrustation behavior.

The effective long-term use of indwelling urinary catheters has often been hindered by catheter-associated infection and encrustation. In this study, the suitability of poly(ethylene oxide) (PEO)-based multiblock copolymer/segmented polyurethane (SPU) blends as coating materials for the commercial urinary catheters was assessed by measuring swellability, bacterial adhesion, and encrustation behavior. When exposed to PBS (pH 7.4), the blends absorbed a significant amount of water, which was proportional to the copolymer content. It was demonstrated from bacterial adhesion tests that compared to bare SPU, the blend surfaces could significantly reduce the adhesion of E. coli, P. mirabilis, and S. epidermidis; the number of adherent bacteria correlated with the amount of copolymer additive. indicating that the swellability of the blends affected bacterial adhesion. Of the bacteria studied, the greatest effect of the copolymer additive was observed in S. epidermidis adhesion, in which there was an 85% decrease compared to bare SPU with a small amount of copolymer additive as low as 5% based on a dried blend. By using an artificial bladder model, allowing the catheter to be blocked by encrustation, it was revealed that the blend surfaces could effectively resist encrustation. The duration of patency was extended up to 20 +/- 3.1 h on the blend surface containing 10% of the copolymer additive, whereas the silicone-coated catheter, a control, required the least time for blockage, 7.8 +/- 3.1 h. The superior characteristics of the blends compared to other surfaces might be attributed to their PEO-rich surfaces, produced by the migration of PEO phase in the copolymer chain of the blends in an aqueous environment, and provide promising potential as a coating material on the urinary catheter for long-term catheterization.